Thursday, March 31, 2016

Thoughtful Thursday: Buckminster Fuller

 A different kind of life.


This quotation has been living on my desk for the past two weeks, and it has challenged me every time I have paid attention to it.

I know that this quotation was true to what happened when I first heard about music therapy. From that moment, in a dusty music classroom at the University of Evansville, at a fine arts professional seminar through Girl Scouting, I heard the words "music therapy." Just hearing those two words were magic for me. I actually heard an audible click in my brain and knew that I was meant to do this job. I had a similar click when I realized that some music therapy clients were those with diagnoses on the Autism Spectrum. I knew that I needed to work with persons with those extraordinary brains through music and music therapy. Click.

Lately, my life has changed, and I am not sure what I really want to do with myself anymore. I still love being a music therapist. I still love working with individuals in the music therapy environment, but my current environment doesn't really seem to fit me anymore. I am spending lots of time thinking about what I really want to do these days.

I know these things to be true about me.
  • I still want to be a music therapy clinician.
  • I need a job that will challenge me but will still be able to accommodate my changing physical needs.
  • I am a better employee than entrepreneur.
  • I am very interested in helping other music therapists be the best music therapists they can be.
My path is currently unclear, but I am starting to figure out where I go from here. It's kinda funny, but I want to hear a click again. I've heard some little clicks in my head lately during conversations with my friend Janice (not so subtle today, hunh?), but I haven't really been able to think those ideas through to fruition. (That's also part of my problem. I want every thing to be settled before I leap - not always a good idea. Sometimes you have to just jump!)
The one thing I know for sure is that I do find satisfaction in what I really want to do. I always have and always will.

This is the view from the computer this morning. Is it any wonder I can get ANYTHING done?

Happy Thursday, fellow therapists.

Wednesday, March 30, 2016

This may be a short post. Be prepared.

This has been a long night, and I don't really feel well, so I think I'll just put a couple of thoughts down on this blog and then go to work. I know, I know. Go to work? Yep. I have to. I have no more sick time so I have to go to work.


There have been several themes that have popped up in my life this week. The first is self-care. The second is perfectionism and anxiety. I don't know if Facebook is in any way linked to this blog (probably is - hello, Big Brother), but things have been popping up on my newsfeed about both of these topics. 

I spent some time working through my first art journaling assignments in my e-course - The Art of Imperfection. I will be continuing. Friends have been posting links to articles, memes, and other links about these topics as well. I don't think that many people know what I am currently seeking, but they seem to be seeking the same. I think that's why they are my friends.

Have a good Wednesday.

Tuesday, March 29, 2016

TME Tuesday: Name That Tune

You know this game, right? It's a great standard for groups working on reminiscence, theme-based programs, music awareness and preferences, and is just plain fun. You know the game, so I'm not going to post too much information about how to play, but here are some ways to change the game to accommodate different group members... If you have additional ideas, then post them in the comments either here or in Facebook! I would love to see your ideas!

  • Play in competitive teams who play as the game was presented on television long, long ago - each team takes turns stating how many seconds they need to identify a song. When both teams agree on a time frame, play the music for that amount of time. The team that is the identifying team has to figure out the song in the amount of time indicated to get a point. The other team can steal the point if the first team cannot.
  • Play Family Feud style where two clients go head to head and then take control of the music field until they strike out. The other team waits to take control back.
  • Non-competitive Version - The group plays against the therapist. The therapist gets points if he/she can stump all group members with song selection. In addition, I set up this proviso that I get points when group members are rude to each other or interrupt (we work on impulse control). The group gets points when they can identify a song through working together.
  • Play several different songs that have a common theme. Group members are trying to figure out the theme rather than the names of songs.
  • Try different versions of songs to increase complexity - I have some Disney music that is presented in different styles, so I will play my version of Hakuna Matata that is presented in the style of Strauss. It takes me sharp-eared clients more time to figure out the root song, but they can do it eventually.
How do you play Name That Tune with your clients? Let me know!!

Monday, March 28, 2016

Presentation Mode Commencing in 3...2...1

Just kidding. I'm not presenting anything right now, but I am thinking ahead to several other presentation opportunities. I have a bunch of ideas percolating in my head, and I am in the process of refining my ideas into presentation proposals. (No spoilers here since I don't want others to see my ideas...yet.)

I like being a presenter. I enjoy public speaking, and music therapists are my favorite audience. I get to talk (which I enjoy) about my favorite topic, being a music therapist (which I love), so presentations are something that I look forward to and heartily relish.

I have a small book that has my presentation ideas in it. It joins my small books that hold my business ideas and my wild ideas in a small notebook that I can carry around with me. I am going to spend some time fleshing out my ideas so I can start to put them into the AMTA proposal website. I also have to create my TMEs for a project that I have going with another MT-BC - so I can keep up with every project that I'm juggling right now.

Thinking about presenting is always fun for me. I try to imagine what other music therapists out there want to know, and then I go from there. I often start with what I want to know and then I get an opportunity to learn what I want to know.

So, I will be immersed in topics that intrigue me this afternoon. I hope you find something that you can immerse yourself in, and then write a proposal. Others will also want to know.

Sunday, March 27, 2016

Supplemental Sunday: Stereo Symbol Movement

I think I've shared this before, but here is a bonus TME for you that uses visual aids to assist in the development of independence and life-long leisure as well as gross motor development, body awareness, vestibular and proprioceptive awareness, and social interaction. 

Looking for the symbols so you can make your own? Go to your nearest iPod/mp3 player/CD player. The symbols are almost universal these days.

Stereo Symbol Movement
Therapeutic Music Experience
Mary Jane Landaker, MME, MT-BC

Purpose: To increase independence in lifelong leisure skills; increase familiarity with common symbols for electronic media operation; symbol recognition; divided attention to task; sustained attention to nonverbal cues; social interaction

Source: Original idea. © April 26, 2010, by Mary Jane Landaker, MME, MT-BC

Materials: Stereo symbol cards (Play/pause, stop, fast-forward, rewind); music source; OPTIONAL: dot spots to coordinate movements

Environment: Large space for movement – no chairs needed or wanted for TME; central location for leader to sit where he/she can be seen by entire group

Music: Recommend that music be used as background figure – moderate to fast tempo with or without lyrics to assist clients in continuing to move as directed

Procedure: R = Reinforcement opportunities; C = Redirection/Cue opportunities; A = Assessment
  1. Start TME by reviewing symbols.
  2. C=Ask clients what the symbols are, and accept all appropriate answers (arrow and lines, triangles, play, stop, etc).
  3. R= reinforce all responses.
  4. A=Note which clients are familiar and which are not familiar with the symbols
  5. Direct clients to stand and spread out in the space.
  6. Turn on the music.
  7. Display the first symbol.
  8. C=explain the desired movement. Play/pause = moving/ dancing as wished; Stop = freeze in place; Fast-forward = move in forward manner; Rewind = move backwards
  9. C= remind clients to watch for changes in the symbol presented by the leader
  10. A= watch who can attend visually
  11. R= compliment clients who change when cued. Redirect clients who do not appear to be attending to visual stimulus
  12. Change symbols as desired, offering opportunities for client success and continued visual attention
  13. R= continue to reinforce clients for appropriate completion of cues
  14. R= choose client to take place of the therapist
  15. Repeat steps 7-14, continuing to reinforce group members for attention to task and appropriate interactions.
  16. Close the TME when clients start to show signs/symptoms of no interest, fatigue, or increased arousal

Therapeutic Function of Music: Music acts as motivator in this TME as it is an environmental stimulus to encourage continuous movement. By including music that has a moderate to fast tempo, the clients have the rhythmic impetus to move. However, the music may also act as a distraction for clients who have difficulties with attending to multiple forms of stimulation simultaneously. Clients with many difficulties may respond better to a sung stimulus paired with a visual stimulus rather than the use of music as a background figure.

·         Decrease stimuli by removing background music and using a song that includes the directives displayed by the leader
·         Use targeted symbols to decrease number of desired responses – e.g., use only play/pause and stop symbols

  • Pair visual stimuli with auditory stimuli – e.g., play/pause sign with specific melodic figure, stop sign with different melodic figure. Play melodic figures randomly without regard to the visual stimulus to assess attention to stimulus form as well as to assess attention to task
  • Encourage clients to develop own movements for symbols. Keep movements somewhat aligned with what the electronic medium does when specific buttons are pushed.

Saturday, March 26, 2016

Becoming a Research-Informed Clinician - Part 5

I've done it.
This is how I'll organize my thoughts...

I've refined my process for reading research so that I can use the ideas presented in my very own clinical practice. I have figured out what I want to learn from my reading, how to organize it, and how to then synthesize the information into something that makes sense to me. Here is the format for my thoughts and process. It is the finished product as the first reading doesn't look this neat. (Click this link to get to my website and download the file...)

Here is an example of what reading a research article looks like around me...

My first read-through of any type of research article or book requires many different colors of post-it notes. I usually use about 6 different colors. Each color has a specific significance for the article. (I always make a color legend so I know which color is which.) In the picture below, the light pink indicates terminology that I need to further define. The blue slips are additional references to look up and read. The purplish slips are things to takeaway into my practice (there were more of them earlier - I wonder where they went...), and the orange ones are quotations from the article that resonated with me in my reading. I also had some different slips for theory/philosophy ideas. I usually take my notes as I read and then organize them onto the file later on.

My next step in this process is to start making a master list of takeaways that I can use during advocacy moments, job development, and clinical decision making. I have that list started with the reading I've done recently. I just received the Spring 2016 edition of the Journal of Music Therapy, so I will dig into that pretty soon to increase my research repertoire. 

I have my journal, I have my post-its, and I am now just waiting for the time to read through one of the latest articles. Stay tuned for more as I keep wading through this process... 

Thursday, March 24, 2016

Thoughtful Thursday: Never Underestimate the Importance

Isn't it amazing how everything just starts to come together and that patterns are apparent when you start focusing on something important?

I am on a quest to be okay with not being perfect. In the past two weeks, I've signed up for a course on The Art of Imperfection with Brene Brown, I've gathered all my materials to start, and I am reading the book, one chapter at a time. In the past two weeks, I have noticed more and more memes, news items, articles, and comments from others about perfectionism.

Now, I don't know if there has been a recent upswing in these types of things in my environment or if they have been there forever and I am just more likely to notice these days. (I really suspect a combination of both.)

I received a message yesterday from a friend of mine who noticed that I didn't post anything on this blog. She inquired if I was okay.

This was important. It was important to me and made me realize that there are times when perfection (which I was striving for by being SuperTherapist this week [I have a cape waiting for me in California - REALLY!] and working through someded breathing difficulties) is more harmful than good. I was feeling guilty about taking my last day off in order to stay home, get on the heavy-duty (and full of side-effects) medication, and nebulize so I could breathe without coughing, but that friend asking me if I was okay remind me of the importance of self-care.

A simple request shook me out of my preoccupation (and guilt about being at home) and reminded me that it is important to take time to be better. All of a sudden, many of the things that I saw in my environment started to reinforce the idea of needing to care for self and soul.

Guilt is a powerful emotion, but it does need to be managed and limited. There is no reason to feel guilty about taking time to manage your breathing. I know my clients will have missed me (and they will tell me over and over), but I also know that I cannot do music therapy if I cannot breathe so I have to prioritize. There are times when breathing is more important than clients. Yesterday was one of those days.

Today I can manage to go to work and manage breathing treatments as well. The major side effects are diminished and the rest of the side effects are things I can sing through (if I take my nebulizer with me and do regular breathing treatments). 

Never underestimate the importance of two things - noticing something and self-care.

Tuesday, March 22, 2016

TME Tuesday: Take a Song

I just had an idea for a therapeutic music experience (TME) flash into my head, so this is not as put together as my TME Tuesday posts usually are. Please forgive me for being so spontaneous, but these things happen and are usually good for me!

So, this idea is influenced by something I saw on Pinterest. The idea was to encourage adolescent girls to take lyrics from a specific song and then make them into a collage with self-esteem images and art journaling. My clients are not really able to fully immerse themselves in the reasons why we would do something like this. Most would be able to complete the concrete parts of this experience, but the deeper thought would be difficult for them to complete. They just don't connect the process with a product or challenge for themselves.

They often have the same difficulty with lyric analysis - I think it's in the personalization of the lyrics where we struggle the most. Many of my clients can use their vocabulary skills to think about what the lyrics mean, but they don't really think about what it means to them. The processing part of a lyric analysis just doesn't really work.

So, here is what is starting to percolate in the back of my brain...

I am thinking about using a song - a preferred song suggested by one or more of my clients - and making lyric strips for different parts of the song. Each client or small group of clients gets a couple of lyric strips - enough for an entire verse of the song. It is their job to arrange the strips into a story. (That's how I explain lyric analysis to my clients - every song tells a story of some sort, and it's our job to figure out what the story is and what it means to us.) There is no wrong way to arrange their lyrics - it is their story. Once the lyrics are arranged, the new song is performed for the group to experience and then talk about.

If I got REALLY organized, I could print out the melody lines with these phrases so we could put together new melody lines. Hmmm. Things to think about.

So, what makes this music therapy?

As is, not much, so it is up to me, the music therapist, to change this from a talk therapy strategy accompanied by music into a music therapy experience.

I, as therapist and musician, can work with clients on how they want their music presented. Working on executive function through offering suggestions and examples of what their new lyrics sound like with differing musical elements. We can discuss the ways that changes in our music can change how people think about our music. We can find ways to present our newly arranged music to reinforce specific themes or thoughts. For me, that is the type of thing that moves a TME like this one from something that anyone can do to something that I can do with my unique training, understanding of music and musical elements, and my role as a music therapy professional.

This is going to require some more thought as I try it with my clients. Well, I'm off to think about this a bit more. Happy Tuesday!      

Monday, March 21, 2016

Monday Morning

4 am comes very early after a time change and a week of sleeping in. It's time to go back into the work routine, so it's time to wake up and get ready.

It's been a week since I have been in the music therapy room at my facility. 

This week has been full of napping, trying to figure out what to do with my life, and cleaning bits and pieces of my home. It has been a good week, but it is now time to get back into the music therapy clinician routine. I have a very small idea about what I am going to do with students this week. We are going to figure out our Musician of the Month through word scrambles, music listening, and discussion. Other than that, my current session plans are wide open. They will be more firm as of this morning at 8:30 am (the first kids arrive at 9 am).

Mondays are my plan and preparation days. I do not have an afternoon group, so I get some time to arrange and organize the next couple of weeks. I hope I can concentrate. When I am medically cleared and off of light duty, I will be doing individual sessions, but right now, I am not able to be alone with kids, so I just have lots of time to make plans. I am hoping to be allowed to start kneeling pretty soon so I can get back into behavior management training and 1:1 sessions, but it's not looking good. Darn injuries!

I've put together a lunch for later today. I have arranged my goal list for this week. I have an idea about what I am going to do with some of my clients, and I am looking forward to getting back into my work routine. All-in-all, a good break.

I think I am starting to wake up now. Have a great Monday!! 

Sunday, March 20, 2016

Supplemental Sunday: Drawing Things
I am not the best artist in the world, but I find lots of joy in drawing. I've found that I'm pretty good at line drawing, especially if I have something to look at as a model. This art, however, was drawn (almost) without example and completely for use with one of my favorite Sesame Street songs, I Don't Want to Live on the Moon

Now, I could find images on Google for my visual aids (and I often do so), but there is something very satisfying about drawing my own visuals.

So, how do I start?

I listen to the music and read the lyrics. I find key terms that I can actually draw. Some songs are completely abstract - I don't often find success drawing things that aren't concrete - so, those songs are not really good for making visual aids. (Home is one of those abstract concepts, and my clients come from many different homes, so I wasn't really able to draw a good picture of what home is to us.)

I make a grid - this one was folded into eighths. I was able to draw one concept per section of the paper. If you look closely, you can see the grid lines.

I try drawing things on scrap paper until I have a picture that illustrates what I want my clients to know about the song lyrics.

After I have a picture that I like, I draw it on the grid. 

Then, I add words in a clear print (to help my students read - a fancy font can make things difficult to interpret for some of my clients).

After all of that, I scan it into my computer so I have an electronic copy of my artistic endeavours.

If desired, I then color my original artwork and scan it again. (You didn't get the colored version because the file was too large.) Now, I have options for how to download my art. I can print it on paper or on cardstock. I can use colored paper or white paper. I can make the visual aids large or small - all through the magic that is my computer!!

If you are someone who doesn't feel comfortable drawing, then don't do it. If you want to draw, then just start. Don't let the fear of what others might think or say stop you.

Saturday, March 19, 2016

It's Important

I am sitting here, trying to figure out what to write about this morning. It is almost the end of Spring Break, and I am sitting in my "in progress" cleaning process. I have a meeting in less than an hour, so I am not really able to do much of anything else right now. I could start a load of laundry and let that run while I am meeting. I could also keep ripping CDs to my computer. I could do both of those things simultaneously! Be right back!!

Okay, that's started. This has been a good week. I did the things that I had to do, but spent the rest of the time doing things that I wanted to do. I spent some money on more scrapbooking and paper tools for making visual aids. I grocery shopped and made some food for later this month. I finished my taxes and the tax process for the not-for-profit business that I am part of. I am getting ready for an influx of money that will allow me to move into new business practices. I made some progress on a project that I am doing with a good friend of mine (she knows who she is!!).

I also took naps, ate chocolate, made brownies, and spent lots of time reading things for fun. I washed dishes in the dishwasher and by hand. I ate chips and dip when I wanted to - even at 6:30 in the morning!

The rest of today will be spent in meetings, in projects, in freezing food for later on. I hope to play a bit with my new scrapbooking tools to make something new for tomorrow's Supplemental Sunday post. I also will spend time talking to my family about their day. My mother and my sister are just starting their Spring Breaks, so they are where I was a week ago - ready for some relaxation.

I am ready to go back to work... I think.

While I love being at home for some R&R, I also love my job and my work. When I return to work, some of my clients will be gone. I will have new clients to work with and get to know. Some of my clients will be glad to see me. Others will not be so happy that I am around. I will be spending time writing session plans and getting things ready for them. There is something comforting about routine and working.

Self-care is something that has become very important to me.

There was a question on social media lately about taking time off. I believe fully in the use of sick days and planned vacations. A therapist who doesn't take time away from therapy cannot be a good therapist - there is just too much that other people take. You have to refresh yourself or you end up burning out.

An occasional day off is essential to my self-care process. A lazy vacation is also essential.

I am going to go to my meeting now. Have a refreshing day. Take care of your self. 

It's important.

Friday, March 18, 2016

The Music in Music Therapy

Last night, I had a chance to talk about one of my favorite music therapy topics to some of my favorite music therapists - interns! We talked about becoming more purposeful in how we use music in our therapy sessions. This is my favorite thing to ramble on and on and on about, and sometimes it leads to deep discussions about our therapeutic modality. Sometimes we just ponder what is going on as we think more deeply about what it is we do that makes us different from other musicians in our area, facility, or location.

I have an ulterior motive for talking like this to music therapy interns.

I think that many of us practiced veterans of the music therapy profession do not really know how to talk about music therapy to people who make funding decisions. I think this is why we are sometimes replaced by other music programs - we don't know how to delineate what we do that makes us different than the other musicians who interact with clients.

This is something that we seem to struggle with each and every day. I see lots of posts on social media sites about the fact that other people are doing things with music that we often seem to feel belong solely to us. Many times, the poster (person who posted the post) is outraged that someone else is using music for a therapeutic purpose. Now, I don't like when someone advertises a recording as "music therapy," but if someone else is talking about the benefits of music listening without the label, I think there is nothing wrong with that.

It is my job, as a representative of this fine profession, to promote the benefits of music in the world. It is also my job to explain why having a music therapist interact and engage with clients increases those same benefits for clients in ways that simply listening to a recording just cannot accomplish. I think this is where we often fail as an entire profession.

I often hear new therapists attempt to explain what happens with clients during music therapy sessions. Comments like "You just have to see what happens," or "No one knows why he/she responds to music like this" don't really inform others about what is going on in a music therapy session. I ask therapists to tell me what they were doing with their music during a particular time in a session. They often cannot tell me what they were doing with their music. This is where we fail.

We all know that music has effect on different body systems, functions, and responses. We have this background, but I have found that we don't link that background knowledge to what is happening in music therapy sessions. We can't explain that decreasing our tempo allows for clients to interact in ways that they simply cannot coordinate at faster tempi. There is lots of research out there that supports the use of music for all types of outcomes, but most of that research is not readily available to music therapists out in the world. We have to know what others are learning about the brain and how music is interpreted in order to discuss why music therapy should be part of every hospital, school, long term and short term treatment program, and wellness program.

When I discuss music therapy with other people, I find that they always have some sort of experience with the therapeutic benefits of music - often a personal experience of how they use music to help them do something or the other. When they state that they do music therapy, I start with what they think is music therapy and then try to demonstrate that music therapy goes so much more deeply than simply listening to music.

When I talk to folks who are making budget decisions about music therapy, I hear things like "Why should we hire a music therapist? We bought this listening program." (These tend to be the types of conversations that drive music therapists crazy.) I take a positive tack. I'll say things like "I am so glad that you know about the benefits of music for your clients. One of the important things to know is that music therapy is different from music listening. A music therapist can actively use both live and recorded music to further enhance the quality of life for your clients. Here's what I can do to make that program so much more beneficial and how I can use music to further client progress and interaction..." 

This doesn't always lead to a job, but it does lead to a conversation about why music therapy is different from a music listening program. I then have to be prepared to demonstrate what music therapy can do with the clients right there.

That's where my thoughts about the active and purposeful use of music come into play.

I have to know how to use my therapeutic modality in ways that promote my clients' progress towards their goals and objectives. I have to be able to talk about what I am doing with that modality in order to let others know that there is so much more to what is happening in a music therapy session than just luck. There is a purposeful selection of musical elements and a purposeful application of those selected elements to engage clients.

Sorry for the soapbox - I am thinking this is going to be a personal crusade that I will NEVER relinquish. Okay... it's that already.

Spend some time thinking about how you are using music with your clients. Think about those that don't respond. What could you change musically to possibly get a response from them? Try it. See if the response changes. If it does, make a note of what element you changed and the response it got. If it doesn't, adapt the music again.

Many music therapists do these things without thinking about them. You notice that little Kirby is sitting on the fringes of the group, trying to move with the rest. but not quite getting there. Most therapists would slow down the tempo of the music or find other ways to assist little Kirby to complete the task. We just don't really know how to explain what we are doing (it's natural for us to do this, but not talk about it).

We have to be able to talk about it or we will be replaced.

Stepping down from this particular soapbox now...